Noah found Dr. London’s name in OR 8, the same operating room where the Vincent debacle had occurred. She’d been scheduled to “pump gas,” which was the anesthesiologists’ humorous description of their job, for a bariatric surgery case that had started at 1:30 P.M. But just as Noah was reading the entry, its color changed from blue to yellow, conveniently signaling the case was over.
Thinking she’d soon appear in the PACU, or post-anesthesia care unit, Noah wandered in. Most of the beds were occupied as a testament to BMH’s surgical volume, even on a Friday afternoon. His intention was to wait for Dr. London to appear, which he assumed would be imminent. He was surprised to find her already there, signing off on her patient to the PACU staff. Noah walked over toward the foot of the bed. The patient was enormous. Noah estimated he was well over three hundred pounds. Noah had become good at estimating human weight after his rotation on bariatric surgery as a senior resident. He was well aware that handling such patients was an enormous challenge for the nursing staff.
Noah listened while Dr. London gave the last of her instructions to the PACU nurse and then did something that surprised him. She gave her mobile number with the comment that if there was any trouble whatsoever to give her a call. Noah was impressed. Such personal follow-up was not the rule, as there were always in-house anesthesiologists available 24/7.
When Dr. London was finished, she abruptly turned and practically collided with Noah. He assumed she was eager to be on her way, which he interpreted as less than auspicious. Since Friday afternoon was the beginning of the weekend in most people’s minds, Noah immediately worried he might not get to talk with her until Monday.
“I’m sorry,” Dr. London said. Her voice was soft and clear but with a touch of an accent that Noah had never been able to identify.
“Not at all,” Noah said. “It’s my fault for sneaking up on you.”
Dr. London stared at Noah with her striking blue eyes as if surprised by his comment.
“Well, I really didn’t sneak up on you,” Noah corrected. “But I did want to ask you if I could talk to you briefly.”
With a quick glance at her watch, suggesting she might have a pressing engagement, she asked what he wanted to speak to her about.
“The Bruce Vincent case,” Noah said. “I have to present it at next Wednesday’s M&M Conference. It is important that I get your input.”
Dr. London’s response was to look back at the nurse taking care of her last patient and then at the other nurses working around the room. She was clearly suddenly ill at ease.
“I have been devastated by the Bruce Vincent case,” Dr. London confided in a lowered but emotionally strained voice. Her eyes zeroed in on Noah like lasers. “It was my first operative death. I went over the case a dozen times and found nothing, absolutely nothing, that I could have done differently. Well, that’s not entirely true. I could have waited for Dr. Mason to be in the room before starting the anesthesia. But he insists otherwise and is supported by Dr. Kumar. That’s the reality, so I don’t think I can add anything. I’m certain the outcome had nothing to do with anything I did or didn’t do.”
“Okay,” Noah soothed. He was completely taken aback by Dr. London’s unexpected vehemence. She was staring at him with uncamouflaged intensity. “I certainly empathize with you about it being your first operative death. I’m sorry, really I am, and I know it can be difficult. But I have to warn you that Dr. Mason plans on blaming Anesthesia. He told me directly. I would like to avoid what might cause a problem for you and the Anesthesia Department, but I need your help.”
“This is not a good place for us to talk,” Dr. London said. “Do you have a private office?”
“I don’t,” Noah said, again wishing such was not the case.
“I don’t, either,” Dr. London said. “Maybe we can find a place in the surgical lounge. We can at least sit and not stand out like sore thumbs.”
“Okay,” Noah said, even though he thought the idea ludicrous if she was looking for privacy. But then he remembered on Friday afternoons it was far less busy than during the week, especially in the summer, with a lot of doctors and nurses heading off to the Cape and the Islands.
“I’ll meet you there in ten minutes or so,” Dr. London said. “I have to finish up here.”
When Noah got to the surgical lounge, he realized his first fears were entirely founded. The room had been commandeered for an impromptu party for one of the OR nurses who was going off on a vacation cruise. There were even some bon-voyage decorations draped over the windows. Despite strong misgivings that Dr. London was not going to find the lounge any better than the PACU, Noah pulled a couple chairs into the far corner apart from the main crowd. Most of the revelers were grouped around a spread of snacks on the countertop at the kitchenette end of the room.
As she had promised, Dr. London soon appeared, and Noah could tell that she was not pleased to find a party under way. Nevertheless, she started toward Noah, who had waved to get her attention. He watched her as she approached. The way she carried herself reemphasized his impression of her as being lean and fit, as well as suggesting a certain confidence. At the same time, he again marveled at how little he knew about her, despite all the times they had worked together. The only thing he did know was that she was a highly competent board-certified anesthesiologist on the staff of one of the country’s premier tertiary teaching hospitals, which meant she had been seriously vetted. From Noah’s conversations with others, his sense was that no one knew too much about her. Although superficially friendly, she was indeed a private person.
“This is not what I had in mind,” Dr. London said as she took the seat catty-corner to Noah’s while glancing over her shoulder at the merriment.
“At least they are engrossed,” Noah said, just as OR supervisor Janet Spaulding spied them and immediately broke from the group and approached.
“Well, I wouldn’t believe this if I didn’t see it with my own eyes,” Janet said. “My two favorite party poopers comparing notes.” She laughed to convey that she was teasing. “It’s nice to see you two chatting. I don’t think I’ve ever seen either one of you socializing in here. But whatever, please join us. Don’t be strangers. We’re giving Janice a proper send-off.”
“Thanks, but I unfortunately have to get going,” Dr. London said before Noah could respond. “I’m already late for an engagement. Dr. Rothauser and I just needed to talk briefly about a case.”
“Well, if you change your mind, we have plenty,” Janet said, gesturing back toward the food and drink. She half waved before returning to the festivities.